Cannabinoid Use for Appetite Stimulation and Weight Gain in Cancer Care: Does Recent Evidence Support an Update of the European Society for Clinical Nutrition and Metabolism Clinical Guidelines?

Повышение качества оказания помощи больным новой коронавирусной инфекцией COVID-19 возможно только на основе мультидисциплинарного подхода. Оценка пищевого статуса и при необходимости его коррекция являются важной составляющей комплексных программ лечения и реабилитации таких больных. Значительное число пациентов с COVID-19 составляют люди пожилого и старческого возраста, у которых уже есть признаки нутритивной недостаточности. Нарушения питания и сопутствующая им саркопения – факторы риска неблагоприятного течения COVID-19. Прогрессирование саркопении при COVID-19 объясняют возникновением вирусного миозита, миопатией, спровоцированной цитокинами, и иммобилизацией. Уменьшение мышечной массы ассоциировано с плохим прогнозом заболевания и снижением качества жизни. Коррекция нарушений пищевого статуса больных COVID-19 должна проводиться на всех этапах лечения. Важность проблемы нутритивной поддержки отражена во множестве публикаций, посвященных лечению больных COVID-19. Необходимо заметить, что Европейское общество клинического питания и метаболизма (European Society for Clinical Nutrition and Metabolism, ESPEN) в кратчайшие сроки выпустило рекомендации по нутритивной поддержке больных новой коронавирусной инфекцией, что лишний раз подчеркивает актуальность проблемы. Это стало логичным продолжением рекомендаций по коррекции пищевого статуса больных, находящихся на лечении в отделении реанимации и интенсивной терапии. Аналогичные клинические рекомендации были разработаны в Великобритании, Бразилии и целом ряде других стран. Использование препаратов для перорального дополнительного питания в большинстве случаев позволяет обеспечить потребности пациентов в необходимых нутриентах, уменьшить выраженность саркопении и повысить эффективность реабилитационных мероприятий. Improving the quality of care for patients with the new coronavirus infection COVID-19 is possible only on the basis of a multidisciplinary approach. Evaluation of nutritional status and, if necessary, its correction are an important component of comprehensive treatment and rehabilitation programs for such patients. A significant number of patients with COVID-19 are elderly and senile people who already have signs of nutritional deficiency. Eating disorders and accompanying sarcopenia are risk factors for the adverse course of COVID-19. The progression of sarcopenia in COVID-19 is explained by the occurrence of viral myositis, myopathy provoked by cytokines, and immobilization. Decreased muscle mass is associated with poor disease prognosis and reduced quality of life. Correction of nutritional disorders in patients with COVID-19 should be carried out at all stages of treatment. The importance of the problem of nutritional support is reflected in many publications devoted to the treatment of patients with COVID-19. It should be noted that the European Society for Clinical Nutrition and Metabolism (ESPEN) promptly issued recommendations on nutritional support for patients with new coronavirus infection, which once again emphasizes the urgency of the problem. This was a logical continuation of the recommendations for correcting the nutritional status of patients undergoing treatment in the intensive care unit. Similar clinical guidelines have been developed in the UK, Brazil and a number of other countries. The use of drugs for oral supplementary nutrition in most cases allows to meet the needs of patients for the necessary nutrients, to reduce the severity of sarcopenia and to increase the effectiveness of rehabilitation measures.

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Malnutrition according to the European Society of Clinical Nutrition and Metabolism (ESPEN) definition and falls in general older population: Findings in the EPIDOS study-Toulouse cohort

Clinical Nutrition ◽

10.1016/j.clnu.2019.11.013 ◽

2020 ◽

Vol 39 (1) ◽

pp. 318-319

Author(s):

Dolores Sánchez-Rodríguez ◽

Yves Rolland ◽

Cédric Annweiler

Keyword(s):

European Society ◽

Clinical Nutrition ◽

Older Population

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Care of adolescents and young adults with cancer in Asia: results of an ESMO/SIOPE/SIOP Asia survey

ESMO Open ◽

10.1136/esmoopen-2018-000467 ◽

2019 ◽

Vol 4 (3) ◽

pp. e000467 ◽

Cited By ~ 1

Author(s):

Chi Kong Li ◽

Rashmi Dalvi ◽

Kan Yonemori ◽

Hany Ariffin ◽

Chuhl Joo Lyu ◽

...

Keyword(s):

Young Adults ◽

European Society ◽

Cancer Care ◽

Online Survey ◽

Healthy Lifestyle ◽

Insurance Coverage ◽

Paediatric Oncology ◽

Adolescents And Young Adults ◽

Human Papillomavirus Vaccination ◽

Cancer Services

BackgroundAdolescents and young adults (AYAs) with cancer require dedicated management encompassing both adult and paediatric cancer services. Following a European survey, the European Society for Medical Oncology, the European Society for Paediatric Oncology and the Asian continental branch of International Society of Paediatric Oncology undertook a similar survey to assess AYA cancer care across Asia.MethodsA link to the online survey was sent to healthcare professionals (HCPs) in Asia interested in AYA cancer care. Questions covered the demographics and training of HCPs, their understanding of AYA definition, availability and access to specialised AYA services, the support and advice offered during and after treatment, and factors of treatment non-compliance.ResultsWe received 268 responses from 22 Asian countries. There was a striking variation in the definition of AYA (median lower age 15 years, median higher age 29 years). The majority of the respondents (78%) did not have access to specialised cancer services and 73% were not aware of any research initiatives for AYA. Over two-thirds (69%) had the option to refer their patients for psychological and/or nutritional support and most advised their patients on a healthy lifestyle. Even so, 46% did not ask about smokeless tobacco habits and only half referred smokers to a smoking cessation service. Furthermore, 29% did not promote human papillomavirus vaccination for girls and 17% did not promote hepatitis B virus vaccination for high-risk individuals. In terms of funding, 69% reported governmental insurance coverage, although 65% reported that patients self-paid, at least partially. Almost half (47%) reported treatment non-compliance or abandonment as an issue, attributed to financial and family problems (72%), loss of follow-up (74%) and seeking of alternative treatments (77%).ConclusionsLack of access to and suboptimal delivery of AYA-specialised cancer care services across Asia pose major challenges and require specific interventions.

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Translating the European Society for Clinical Nutrition and Metabolism 2019 guidelines into practice

Current Opinion in Critical Care ◽

10.1097/mcc.0000000000000619 ◽

2019 ◽

Vol 25 (4) ◽

pp. 314-321 ◽

Cited By ~ 1

Author(s):

Annika Reintam Blaser ◽

Adam M. Deane ◽

Joel Starkopf

Keyword(s):

European Society ◽

Clinical Nutrition

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Predictive Accuracy of Calf Circumference Measurements to Detect Decreased Skeletal Muscle Mass and European Society for Clinical Nutrition and Metabolism-Defined Malnutrition in Hospitalized Older Patients

Annals of Nutrition and Metabolism ◽

10.1159/000478707 ◽

2017 ◽

Vol 71 (1-2) ◽

pp. 10-15 ◽

Cited By ~ 36

Author(s):

Keisuke Maeda ◽

Takayuki Koga ◽

Tomomi Nasu ◽

Miki Takaki ◽

Junji Akagi

Keyword(s):

Skeletal Muscle ◽

Hospital Mortality ◽

Muscle Mass ◽

European Society ◽

Skeletal Muscle Mass ◽

Predictive Accuracy ◽

Area Under The Curve ◽

Clinical Nutrition ◽

Receiver Operating Curve ◽

Calf Circumference

Background/Aims: The ability to readily diagnose sarcopenia and malnutrition in a clinical setting is essential. This study is aimed at clarifying the calf circumference (CC) cut-off values for decreased skeletal muscle mass (SMM), according to the Asian Work Group for Sarcopenia's criteria definition of sarcopenia, and those for European Society for Clinical Nutrition and Metabolism-defined malnutrition, in hospitalized Japanese patients. Methods: The study involved 1,164 patients aged ≥65 years. Predictive CC cut-off values were determined using receiver operating curve (ROC) analyses. The predictive validity of the cut-off values was confirmed against in-hospital mortality. Results: There were 654 females and 510 males (mean age, 83.5 ± 8.2 years). Decreased SMM and malnutrition were observed in 80.4 and 32.8% of all patients, respectively. ROC analyses identified CCs of ≤29 cm (female, area under the curve [AUC] 0.791) and ≤30 cm (male, AUC 0.832) as cut-off values for decreased SMM, and CCs of ≤26 cm (female, AUC 0.798) and ≤28 cm (male, AUC 0.837) for malnutrition. CC cut-off values for SMM and malnutrition were independently correlated with in-hospital mortality. Conclusions: The study determined appropriate cut-off values for CC to identify decreased SMM and malnutrition according to the relevant guidelines.

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